The Clinical Core recruits, diagnoses, and characterized AD patients and controls for clinical and basic research. We have recruited men and women from minority groups and from rural and urban areas of Texas and surrounding states. We investigate progression, clinical heterogeneity related to hemispheric specialization, and the neuropathologic basis of this clinical heterogeneity which may help to elucidate subtypes and factors which affect decline in Alzheimer's Disease. We desire a representative population and will therefore enroll ethnic minority subjects through a program for professionals who provide care to minorities. We will work closely with the Education and Information Transfer Core to actualize this aim. Clinical, basic science and neuropathologic projects require appropriate controls, so we will continue entering spousal controls, and have also identified a new source for normal elderly controls. We have expanded our procedures for differentiating familial and sporadic AD. We will provide quantitative measurements of progression using a calculated rate of progression and measured progression rates for cognitive and functional deficits. Our study of progression will attend to relative progression of lateralized behavioral and cognitive problems. In order to increase the duration of follow-up, we have developed a comprehensive Telephone Follow-up Program, and a new instrument to gather data about cognitive and behavioral problems by telephone. We will work with Neuropathology Core and Project 3 to examine site specific anatomical changes using plaque ad tangle counts, synaptophysin strains, and measures of inflammation in brain regions hypothesized to account for lateralized cognitive abnormalities, beginning with aphasia and apraxia. We will continue to explore models for cognitive dysfunction in AD, such as the model for semantic memory tested in Pilot Project 1. Finally, we will continue encouraging researchers from the ADRC and broader medical community to utilize our expertise, database, Serum Bank, and consenting patients and controls to advance understanding of Alzheimer's Disease.